Contrasting Management of Diabetic Patients by General Dentists' Practice Locations

Objectives: General practice dentists (GPDs) have an opportunity to improve patients' oral and systemic health by actively managing patients with diabetes. There are reasons, however, to surmise that GPDs' implementation of this expanded role is limited. In previous analyses, “percentage of patients who pay through Medicaid” was a significant, and positive, predictor of GPDs' active management of diabetic patients. To further examine this finding, this research contrasts the behaviors and orientations of GPDs who practice in lower SES areas vs. GPDs who practice in middle/upper SES areas, in regards to managing diabetic patients. Methods: Data were collected via mail survey of a random representative sample of GPDs in the northeastern US during fall 2002. Responses were received from 105 GPDs (rr=80%). Lower SES GPDs (n=23) had some Medicaid patients and practiced in a neighborhood where approximately 10% or more of residents were on welfare. Middle/higher SES GPDs (n=76) had no Medicaid patients and practiced in a neighborhood where approximately 5% or less of residents were on welfare. T-tests were used to evaluate differences in means between the two groups for selected characteristics. Results: A higher proportion of lower SES GPDs indicated that, for diabetic patients, they more often communicated on a routine basis with the patient's physician (p=.05), as well as referred for/monitored more often the patient's blood glucose levels (p=.03). They also agreed more strongly that their patients expect them to take an active role in managing their diabetes (p=.03); and referred more patients for evaluation of suspected diabetes in the past year (p=.05). Conclusion: These findings indicate lower SES GPDs take a more proactive role than middle/higher SES GPDs in managing patients with diabetes. Such findings are auspicious, given the likelihood that lower SES GPDs see more patients with (un)diagnosed diabetes in their practice settings. Supported by NIDCR DE014898.